title: Linezolid-induced optic neuropathy.
abstract: Many systemic antimicrobials have been implicated to cause ocular adverse effects. This is especially relevant in multidrug therapy where more than one drug can cause a similar ocular adverse effect. We describe a case of progressive loss of vision associated with linezolid therapy. A 45-year-old male patient who was on treatment with multiple second-line anti-tuberculous drugs including linezolid and ethambutol for extensively drug-resistant tuberculosis (XDR-TB) presented to us with painless progressive loss of vision in both eyes. Color vision was defective and fundus examination revealed optic disc edema in both eyes. Ethambutol-induced toxic optic neuropathy was suspected and tablet ethambutol was withdrawn. Deterioration of vision occurred despite withdrawal of ethambutol. Discontinuation of linezolid resulted in marked improvement of vision. Our report emphasizes the need for monitoring of visual function in patients on long-term linezolid treatment.
authors.affiliation: Department of Ophthalmology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.
authors.forename: Divya
authors.initials: D
authors.lastname: Karuppannasamy
authors.forename: Andavar
authors.initials: A
authors.lastname: Raghuram
authors.forename: Devisundaram
authors.initials: D
authors.lastname: Sundar
mesh_terms: D000081:Acetamides / Q000009:adverse effects*; D000890:Anti-Infective Agents / Q000009:adverse effects*; D003937:Diagnosis, Differential; D006801:Humans; D000069349:Linezolid; D008297:Male; D008875:Middle Aged; D009900:Optic Nerve / Q000187:drug effects / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000139:chemically induced* / Q000175:diagnosis; D023303:Oxazolidinones / Q000009:adverse effects*; D012338:RNA, Ribosomal, 23S; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
chemical_list: D000081:Acetamides; D000890:Anti-Infective Agents; D023303:Oxazolidinones; D012338:RNA, Ribosomal, 23S; D000069349:Linezolid